With his presidency now undermined by scandal, Bill Clinton's one chance to
make historic change comparable to what F.D.R. did with Social Security and
L.B.J. did with civil rights may have come in the summer of 1994. After a
year's delay the Democratic Senate was preparing to vote on a version of
"Clintoncare" -- guaranteed health insurance for all Americans. Clinton had
launched the plan in a major speech to a joint-session of Congress the previous
September; the First Lady, heading up a huge staff, had been preparing it since
the inauguration in January, and in his address before Congress the President
saluted her for her unprecedented work. "When I launched our nation on this
journey to reform America's health care system, I knew we needed a talented
navigator, someone with a rigorous mind, a steady compass, a caring heart," he
said. "Luckily for me, and for our nation, I didn't have to look very far. Over
the last eight months, Hillary and those working with her have talked to
literally thousands of Americans to understand the strengths and frailties of
this system of ours...." Hillary Rodham Clinton, as she then still dared
to be known, stood up to a standing ovation.

The President had begun what Haynes Johnson and David S. Broder, in The
System, their 1996 book on the politics of health-care reform, called "a
titanic battle affecting the lives of every citizen and a seventh of the U.S.
economy, that could define his presidency, restore badly eroded public faith in
the political system's ability to serve the people, and redeem a promise more
than sixty years in the making to provide universal health care...." By the
fall of 1994 Clinton had lost the
battle, partly because of a massive advertising campaign -- paid for by the
insurance industry, attacking Clintoncare, and featuring the infamous "Harry and
Louise" commercials, in which a couple worried that under the new plan
government bureaucrats could deny them health care -- and partly because of an all-but monolithic opposition from House and Senate Republicans.

It all seems to belong to another era now, a time of social hope and political
possibility, the high-tide of post-war American liberalism. A defeat for
liberalism, yes, and for the Clintons, certainly; but also, and primarily, for
the millions of Americans without health insurance.

In this season of (increasingly anxious) triumphalism about the surging
economy, in this season of political deadlock in Washington over modest
changes in HMO regulations to protect the already insured, in this season,
finally, of bawdy public talk about Clinton's secretions, the Henry J. Kaiser
Family Foundation has issued a comprehensive report on a much more important
and fitting subject for our public focus.

Uninsured in America: A Chartbook describes the shameful plight of an
estimated 41 million Americans: 18 percent of the nonelderly population, and 10
percent of America's children.

In 1997, the charts tell us, 32 percent of nonelderly adults had been without
health insurance at some time in the previous two years. In 1995 22 million
employed Americans, half of them in full-time jobs for the whole year, were
uninsured -- and not just because they worked for small business: in businesses
with more than 1,000 employees, 20 percent of those earning under $20,000 were
uninsured.

Thirty percent of uninsured adults went without "needed medical care" in 1997,
while 25 percent of uninsured children did not receive needed medical, psychiatric, or dental care. Yet 62
percent of those polled believe that the uninsured can get all the care
they need.

We, the insured, are the problem, of course. Our indifference to those who
desperately need health care -- the 74 percent of the uninsured with an
untreated painful medical condition, the women who forgo mammograms and
the men who forgo prostate exams because they cannot afford the daunting
uninsured cost of care -- is the problem. We are the people, after all, who let
Harry and Louise persuade us that insuring the uninsured would hurt us -- that
common decency toward those with the worst jobs in the country, at the
expanding bottom of the service economy, was something we could just not
afford. There has been an erosion in the national character all right, not
toward loose morals but toward an I've-got-mine complacency, a narrowing to our
families of who we mean by "us." We have reached an ethical dead end. This is a
scandal far worse than anything Bill did with Monica.